New research suggests that brain physiology might account for psychopaths' lack of empathy.

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WEDNESDAY, April 24, 2013 — Psychiatrists, criminologists, and tabloid readers have all struggled to understand what goes on in the minds of psychopaths such as Jeffrey Dahmer and Ted Bundy. A study published today in JAMA Psychiatry puts the blame on the brain, specifically, a neurological absence of empathy in psychopaths.

Researchers at the University of Chicago and the University of New Mexico recruited 80 male prisoners between the ages of 18 and 50 who were incarcerated for murder in a North American correctional facility. They tested the men to find out which ones could be classified as psychopaths.

"We use a very thorough assessment of psychopathy before tagging anyone," said lead study author Jean Decety, PhD, the Irving B. Harris Professor in Psychology and Psychiatry at the University of Chicago, in an email. "A callous disregard for the well being of others and a lack of empathy are characteristics of psychopathy," he added.

Through uniform psychological testing, scientists categorized participants into groups of high, medium, or low psychopathic severity. To decode brain activity that might be linked to empathy among the inmates who ranked, they used fMRI scans (functional MRI) to monitor their neurological reactions to videos illustrating physical harm and facial expressions of pain.

"Given that perceiving pain in others is usually a very strong signal that triggers empathy, and that healthy individuals are predisposed to find distress of others aversive and learn to avoid actions associated with this distress, studying how psychopaths react to such signals is extremely important," Dr. Decety said. "The social nature of pain provides a crucial signal which can motivate helping behaviors in others or inhibit aggression."

Study results revealed that the psychopaths experienced less stimulation in certain areas of the brain — ventromedial prefrontal cortex, lateral orbitofrontal cortex, amygdala and periaqueductal gray parts — associated with behavior moderation, consequence assessment, learning and decision-making, and concern for others. "Psychopaths know the difference between right and wrong, yet they emotionally lack the feeling of what is right and wrong," Decety explained.

"Moral behavior is primarily guided by spontaneous, effortless emotional responses that operate automatically and unconsciously. In the absence of appropriate emotional responding, psychopaths lack motivation to behave morally; their social knowledge is rhetorical and has little influence on behavior," he added.

Surprisingly, researchers also noted that there was increased activity in other parts of the brain — the striatum and the insula — linked to emotion and physical resonance among prisoners classified with high psychopathy rankings, a finding that could potentially be useful in intervention programming.

The age-old debate of nature versus nurture can't be overlooked though, and environmental influences affecting empathy deficits in psychopaths must also be taken into consideration. "Social environment plays a role in psychopathy, and you cannot reduce such a developmental disorder to purely genetics factors," Decety said.

"Environment can mean anything from a birth injury, to influence on a fetus from maternal smoking, to child abuse and peer influences to media violence," said Donald Black, MD, professor of psychiatry at the University of Iowa Roy J. and Lucille A. Carver College of Medicine and author of Bad Boys, Bad Men: Confronting Antisocial Personality Disorder (Sociopathy). "[T]hey all deem to influence the origin and expression of antisocial personality disorder and psychopathy, which is at the extreme end of the antisocial spectrum."

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